Vessel cannulator and clamp for lymphangiography

ABSTRACT

A needle guide is formed with a tubular section and an opened trough section connected thereto in aligned-spaced relationship. A clip member is formed and arranged to releasably engage an open side of the trough section so that a portion of a lymph vessel may be cradled in the trough section and secured by the clip member. During cannulation the clip is held open and a needle is inserted through the tubular section which guides the needle into the cradled portion of the lymph vessel. The clip is then closed and the needle is held in position within the vessel by the pressure of the clip member.

United States Patent 11 1 Weese 128/215 Norman 1- June 4,1974

[54] VESSEL CANNULATOR AND CLAMP FOR 3,469,580. 9/1969 Huddy 128/2153,648,684 3/1972 Barnwell 128/215 LYMPHANGIOGRAPHY 3,687,131 8/1972Rayport 128/2 B [75] lnventor: David Norman, Denver, C010. g [73]Assignee: Becton, Dickinson and Company, Primary Examiner-Aldrich F.Medbery East Rutherford, NJ. Attorney, Agent, or Firm-Kane, Dalsimer,Kane, Sul- 22 Filed: Nov. 13, 1972 and F [21] Appl. No.: 305,869 [57]ABSTRACT 'A needle guide is formed with a tubular section and an [52]28/2 32 4323 opened trough section connected thereto in aligned- 51 I tCl 17/00 spaced relationship. A clip member is formed and ur- [58l JL A20 214 ranged to releasably engage an open side of the trough 1 15872 I347 5 2 section so that a portion of a lymphvessel may be cra- /21' 4died .in the trough section and secured by the clip member. Duringcannulation the clip is held open and a needle is inserted through thetubular section which [56] References Cited guides the needle into thecradled portion of the UNITED STATES PATENTS lymph vessel. The clip isthen closed and the needle is 2,700,385 1/ 1955 Ortiz.. 128/215 held inposition within the vessel by the pressure of 2,880,724 4/1959 Verlarge128/215 the li m mb 3.166.819 Y 9/1965 Robbins ..-27/2l- 3,324.854 12Claims, 7 Drawing Figures VESSEL'CANNULATOR AND CLAMP FORLYMPHANGIOGRAPHY BACKGROUND OF THE INVENTION 1. Field of the Invention.

The present invention relates to lymphangiography apparatus and moreparticularly to a device for guiding a cannulating needle into a lymphvessel and for clamp--- ing the needle in place. I

2; Description of the Prior Art Lymphangiography" is a' valuablediagnostic procedure; however, it has proven to be time-consuming,difficult and tedious for radiologists to perform, particularly thesteps involving cannulating the lymph vessel and securing the needlewithin .the vessel lumen. Lymphangiography is a relatively infrequentprocedure and as a result, many radiologists lack the necessaryexpertise to perform the procedure with ease.

Many lymphangiographic aids have been provided heretofore; however, nonehave offered a reliable means for puncturing the vessel and guiding theneedle into the vessel lumen, which is the most recurrent technicalproblem in the'procedure. On occasions, after the vessel was punctured,the needle passed through the' wall a second time, thereby creating aleak which nessited a secondor thirdattempt with different vessels.

After cannulation was achieved, the needle had to be secured within thevessel and the accepted procedure was to use'a ligature. Whileattempting to secure-the needle with a ligature, the radiologists oftendamaged the vessel. j

In an attempt to avoid the damage caused while using a' ligature tosecure the needle with the vessel, a device was developed wherein a flatplate was fixed to the base of a spring clip so that the plate provideda firm surface upon which thevessel could rest while the upper portionof the clip clamped the vessel in place aroundthe needle. While'thisdevice worked well, inexperienced operators still had difficultypenetrating and cannulating the vessels successfully.- I

SUMMARY OF THE INVENTION The present invention contemplates avesselcannulator and clamp formed from a clip and modified oversizedneedle. The oversized needle is modified to pro- The primary objectiveof the present invention is to provide a device that simplifies thelymphangiography procedure.

Another objective of the present invention is to provide a device forguiding a needle into a lymph vessel and for clamping the needle inplace within the vessel.

- through the wall. of the lymph vessels a second time.

The foregoing objectives and advantages of the invention will appearmore fully hereinafter from a consideration of the detailed descriptionwhich follows, taken together with the accompanying drawings wherein oneembodiment of the invention is illustrated by way. of example. It is tobe expressly understood,

vide a tubular section at one end and an open trough section at anotherend, said sections being connected,

by a portion of the needle from which all but aboutQS Q per cent of theoriginal circumference is removed.

Thus, the tubular section and the trough" section are spaced apart andaligned. The modified needle is then soldered to the base of a-springclip, the needleis positioned on the clip so that an arm of the clipengages an open side ofthe trough section. l

In use, the lymph vessel'is isolated and placed within the open troughso that a needle inserted through the tubular portion will be guided soas'to puncture the lymph vessel and achieve cannulation, after which theclip is released so as to secure the needle within the ves sel. It is tobe understood that the present invention is not limitedto usewith lymphvessels but may be used for cannulating other'types of vessels.

Thus, the present invention provides a convenient means for performingcannulation and for securing the needle within thevessel 1 however, thatthe drawings are for illustrative purposes only and are not to beconsidered as defining the limits of the invention.

DESCRIPTION OF DRAWINGS FIG. 1 shows the device of the present inventionin its contemplated environment and illustrates how a vess el ispositioned for cannulation. v

FIG. 2 is a perspective view of the present invention showing a needleinserted into a vessel and the clamp in position. f I

FIG. 3 is a sectional view taken along line 33 of FIG. 2.

' FIG. 4 is an end view of thepresent invention.

FIG. 5 is a sectional view taken along line 5-5 of FIG.4.

FIG. 6 is a sectionalview taken along line 66;of

FIG. 4.

such as a number 21 needle, so as to include an open trough 12 at oneend and a tubular guide section 14 at another end. A number 21 needlewas chosen because it will receive with a high degree of tolerance a 27I gauge needle, which is the standard size needle used for mostlymphangiography procedures. The trough section 12 has a length ofapproximately 5 mm and is fonned by removing the top portion of theneedle by filing or grinding as most clearly shown in FIG. 7. The

trough andthe tubular section are separated by a 2 mm segment of theoriginal needle from which all butabout of the original circumferencehas been removed by filing or grinding. The tubular section 14 is formedby retaining anentire portion of the barrel of the needle. The outer end15 of the tubular portion may becut perpendicular to the guide or at anangle to facilitate insertion of a needle. The short connecting segment16 serves to maintain a precise alignment between'the tubular section 14and the trough section 12 and to assure the proper spacing between the'section. v

The needle guide 10 is attached to the base 18 of a clip indicatedgenerally as 20. Attachment may be achieved by soldering, welding or byother suitable means. Suitable clips made of a high quality steel are e3 available from Divin'a Distributors, New Haven, Connecticut. The guideis positioned on the base of the clip so that the trough is upright andan arm 22 of clip engages the open side of trough 12.

is made in the skin over the vessel 34 to be cannulated.

The lymph vessel is isolated and a forceps is used to place the vesselwithinthe open trough 12 so that a portion of the vessel is supportedand held along a straight line in alignment with the tubular guide. The'device'is then lifted slightly to create amoderate tension on thevessel and immobilize the vessel as-shown in FIG. '1. The needle 26isinserted into the tubular guidesection 14 and the clip is held in theopen position'while the needle is advance, punctures the vessel andenters the central lumen. The clip is then released so as to secure theneedle within the vessel as most clearly shown in FIGS.2and3.

Since the distance between the tip of needle 26 and the end of tubing'28approximately corresponds to the length of guide 10, the needle may befreely advanced until the tubing engages the guide without fear ofpuncturing the vessel a second time. The same result could be achievedby placing a clamp on the needlela predetermined distance from the tipor by making a markon the needle indicatinghow far the needlermaybe'advanced.

The sides of trough 12 support the walls of the vessel and reduce thepossibility of the needle tip penetrating the vessel in the event thatthe foot moves.

Thus, ties are not required 'to secure the.- needle within the vesseland the needleis relatively secure so that'absolute immobility of thefoot is not required. The present invention provides a device' thatgreatly simplifies the lymphangiography procedure and reduces the 2. Adevice as described in claim 1, wherein the guide means comprises atubular section having an opening formed along the line ofsufficientsize to receive the cannula. r r l 3. A deviceasdescribedinclaim 1, wherein the means for supporting a portion of thevessel comprises a trough formed along the line. e

4. A device as described in claim 1, wherein the means for securing thecannula comprises a clip means for engaging the vessel supporting meansand an exposed portion of the vess'eL- e 5-. A device as described inclaim 4,wherein the clip means includes: r

a base fixedly attached to the supportmeans; and

a movable member for releasably engaging an exposed portion of thevessel supported by the support means. v

6. A device for guiding a cannula into a vessel and for securingthecannula within the vessel, comprising:

. means for supporting a portion of the vessel along a straight linewhich comprises a trough formed along the line; g I

means for guiding the cannula along the line so that the cannula tip maybe advanced to a position within the lumen of the supportedportion ofthe vessel which comprises a tubular member having an opening formedalong the line of sufficient size to receive .thecannula, said tubularmember'and trough being spaced apartto facilitate placing the vesselwithin the trough; and means for securing the cannulawithin thesupportedportion .of.the :vessel. l

7. A device as described in claim 6, wherein the means for securing thecannula within the supported portion of the vessel comprises a clipmeans having a base fixedly attached to the trough and a movable armpositioned to engage an exposed portion of the vessel time required tosuccessfully perform' the procedure.

The device provides a guide for simplifying cannulation and preventing aseco'ndpuncture of the vessel wall. A

clip is provided for securing the needle within the vessel aftercannulation is achieved. The device also helps to prevent the needlefrom puncturing the vessel should motion of the foot occurs afterinsertion of the needle.

What is claimed is: r 1. A integral device for guiding a cannula into alymph vessel and for securing thecannula within the vessel, comprising:

first restraining means on the device forsupporting and securing aportion of said vessel along a straight line;

second restraining means on the device for guidingthe cannula along thesame straight line for positioning the cannula tip within the lumenv ofthe sup- 7 ported portion of the vessel; 1 said second means includingmeans for preventing said cannula from being advanced to a positionwhere the cannula tip punctures the vessel a second time andextends outof said vessel; and

tension means on the device for securing the cannula within thesupported portion of the vessel.

the vessel.

greater portion of its circumference removed along a central portion ofits length.

9. A device as described in claim 8, wherein the oversized needle has alength substantially equal to the length of the cannula so that when thecannula is fully inserted into theoversizedneedle, the tip of thecannula lies within the lumen of the supported portion of the vessel.

' 10. An apparatus as described in claim 1, wherein said tension meanscomprises a biased clip means for securing the cannula within thesupported portion of 11. A method for cannulating a lymph vesselcomprising the steps of;

isolating a portion of the lymph vessel to be cannulated by dissectingsaidvesselaWay from surrounding tissue;

positioning a portion of the isolated vessel on a first clip portionshaped to support restrain and align I the positioned portion of thevessel along an axis; inserting and guiding a cannula along a cannulare-' straining means on a second portion of said clip along said axis;and i 6 penetrating into said lymph vessel lumen with said portedportion of the vessel and the penetrated portion cannula. of the cannulaso as to secure the cannula within the 12. A method as described inclaim 11, additionally supported portion of the vessel. comprising thestep of engaging by pressure the sup-

1. A integral device for guiding a cannula into a lymph vessel and forsecuring the cannula within the vessel, comprising: first restrainingmeans on the device for supporting and securing a portion of said vesselalong a straight line; second restraining means on the device forguiding the cannula along the same straight line for positioning thecannula tip within the lumen of the supported portion of the vessel;said second means including means for preventing said cannula from beingadvanced to a position where the cannula tip punctures the vessel asecond time and extends out of said vessel; and tension means on thedevice for securing the cannula within the supported portion of thevessel.
 2. A device as described in claim 1, wherein the guide meanscomprises a tubular section having an opening formed along the line ofsufficient size to receive the cannula.
 3. A device as described inclaim 1, wherein the means for supporting a portion of the vesselcomprises a trough formed along the line.
 4. A device as described inclaim 1, wherein the means for securing the cannula comprises a clipmeans for engaging the vessel supporting means and an exposed portion ofthe vessel.
 5. A device as described in claim 4, wherein the clip meansincludes: a base fixedly attached to the support means; and a movablemember for releasably engaging an exposed portion of the vesselsupported by the support means.
 6. A device for guiding a cannula into avessel and for securing the cannula within the vessel, comprising: meansfor supporting a portion of the vessel along a straight line whichcomprises a trough formed along the line; means for guiding the cannulaalong the line so that the cannula tip may be advanced to a positionwithin the lumen of the supported portion of the vessel which comprisesa tubular member having an opening formed along thE line of sufficientsize to receive the cannula, said tubular member and trough being spacedapart to facilitate placing the vessel within the trough; and means forsecuring the cannula within the supported portion of the vessel.
 7. Adevice as described in claim 6, wherein the means for securing thecannula within the supported portion of the vessel comprises a clipmeans having a base fixedly attached to the trough and a movable armpositioned to engage an exposed portion of the vessel protruding from anopen side of the trough.
 8. A device as described in claim 6, whereinthe supporting means and the guiding means are formed from an oversizedneedle having an opening therethrough of sufficient size to receive thecannula, said oversized needle having a portion of its circumferenceremoved along a portion of its length adjacent a first end and a greaterportion of its circumference removed along a central portion of itslength.
 9. A device as described in claim 8, wherein the oversizedneedle has a length substantially equal to the length of the cannula sothat when the cannula is fully inserted into the oversized needle, thetip of the cannula lies within the lumen of the supported portion of thevessel.
 10. An apparatus as described in claim 1, wherein said tensionmeans comprises a biased clip means for securing the cannula within thesupported portion of the vessel.
 11. A method for cannulating a lymphvessel comprising the steps of: isolating a portion of the lymph vesselto be cannulated by dissecting said vessel away from surrounding tissue;positioning a portion of the isolated vessel on a first clip portionshaped to support restrain and align the positioned portion of thevessel along an axis; inserting and guiding a cannula along a cannularestraining means on a second portion of said clip along said axis; andpenetrating into said lymph vessel lumen with said cannula.
 12. A methodas described in claim 11, additionally comprising the step of engagingby pressure the supported portion of the vessel and the penetratedportion of the cannula so as to secure the cannula within the supportedportion of the vessel.